People with asthma must stick to their meds amid COVID-19, experts warn

TORONTO --
The greatest danger posed to those with asthma right now is not a pandemic virus attacking respiratory systems, but making unadvised changes to their use of medication that keeps their condition in check, say experts in the field.

This pandemic has created a whirlwind of health misinformation that circulates repeatedly online and through social media. Those with asthma– an inflammatory disease that affects airways – have been a particular target of unproven theories about COVID-19, some based on small studies of non-peer reviewed data in a rapidly emerging health crisis.

Acting on this information will put the more than 3.8 million asthmatics in Canada at risk, say expertswho spoke to CTVNews.ca.

Doctors say that there is no evidence to support one circulating idea that steroids and biologics taken orally or through an inhaler to manage asthma or treat an attack make it harder to fend off the effects of COVID-19.

“There is no data that that’s the case at all,” said Dr. Alan Kaplan, a family physician who specializes in respiratory medicine. “The answer is simple: everyone should keep taking the medicines that their doctor has prescribed.”

He says making changes to any medication on the fly, without physician supervision, will land more people in hospital when health resources are under siege and the risk of contracting COVID-19 is high.

“It’s dangerous to modify your asthma drugs in any way without a doctor’s orders,” echoes Vanessa Foran, president and CEO of Asthma Canada. “This is absolutely not the time to do that. There is a terrible crisis going on in our hospitals right now and it’s critical to stay out of them.”

There is conflicting messaging about whether those with asthma are more likely to experience the most severe effects of COVID-19.

According to the American Academy of Allergy, Asthma and Immunology: “… although the Centers for Disease Control and Prevention states that patients with moderate-severe asthma could be at greater risk for more severe disease, there are no published data to support this determination at this time.”

But the academy did advise that an evolving pandemic means new evidence could change that understanding.

“We don’t think that having asthma make the effects of COVID any worse,” said Kaplan.

“If a person’s asthma is under control, that is better for them handling COVID-19.”

Dr. Anne Ellis, an attending physician at Kingston General Hospital and a professor and chair in the Division of Allergy and Immunology at Queen’s University, agrees.

“Asthma triggers a different armour of the immune system than a viral infection. If you are doing the right things to manage your asthma, you can weather this storm.”

Those with compromised immune systems are considered to be at higher risk of the more severe effects of this coronavirus. But asthmatics, generally, are not consider immunocomprised, says Ellis.

Some who depend on daily doses of steroids to control inflammation in their airways and have been taking steroids for years, she says, may have compromised immune systems, but that’s a small subset of those who have asthma.

Measures to ensure drug supply are welcome, says Foran, especially as reports surface of severe shortages of asthma inhalers in the U.S.

INCREASE IN DEMAND FOR INHALERS

On Monday, Health Canada asked doctors and pharmacists to limit prescriptions of all drugs to a 30-day supply to prevent the kind of stockpiling that has led to empty grocery shelves.

The ministry and the Canadian Pharmacists Association have asked Canadians not to buy more than they need.

“There is no reason to hoard medication,” said Foran. “It creates shortages where there is no need for it. We have reached out to the manufacturers of asthma drugs and they have told us there are no shortages at this time.”

Last week, Saskatchewan's Ministry of Health warned of an "unprecedented increase in demand for inhalers" and said manufacturers and wholesalers were temporarily limiting the number of inhalers pharmacies can purchase in order to prevent a national shortage.”

There is fear out there, says Foran. Asthma Canada’s helpline calls have surged 508 per cent.

“It’s been like a tsunami of need in our community and we are happy we can help people. Everyone is frightened and understandably so.”

The vast majority of allergists and asthma specialists are seeing patients in clinics, where necessary, or through virtual or phone visits, says Ellis. Patients should get their advice from them, she says.

Beyond sticking with their regimen of medicine, experts say those with asthma need to do what everyone else is advised to do to prevent catching or spreading COVID-19: wash their hands thoroughly and often; avoid touching their face; cough or sneeze into their sleeve; disinfect high-contact surfaces; distance themselves from everyone outside of their home; and stay home unless they are seeking medical treatment, are an essential worker, are getting groceries or medications, or caring for someone who is vulnerable.

Foran also advises those with asthma to take care of their emotional and mental well-being at this time of crisis, because stress is known as a trigger for asthmatic reactions.

“There is a correlation between asthma and higher incidents of anxiety and depression. My daughter has asthma and it’s a scary disease at any time. Not being able to breath is terrifying. The depth and breadth of this crisis makes things more scary.”